Stretching after spinal cord injury: a call for evidence for this common clinical practice

Stretching is a ubiquitous rehabilitation intervention for individuals with spinal cord injury (SCI), intended to reduce spasticity, maintain or improve joint range of motion, and prevent joint contractures. Although people with SCI report that stretching is their preferred approach to reduce spasti...

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Main Authors: Todd E. Williams, Louis A. DeMark, Tinuade A. Olarewaju, Kelly A. Hawkins, Emily J. Fox
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Rehabilitation Sciences
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fresc.2024.1505439/full
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author Todd E. Williams
Louis A. DeMark
Tinuade A. Olarewaju
Kelly A. Hawkins
Emily J. Fox
Emily J. Fox
author_facet Todd E. Williams
Louis A. DeMark
Tinuade A. Olarewaju
Kelly A. Hawkins
Emily J. Fox
Emily J. Fox
author_sort Todd E. Williams
collection DOAJ
description Stretching is a ubiquitous rehabilitation intervention for individuals with spinal cord injury (SCI), intended to reduce spasticity, maintain or improve joint range of motion, and prevent joint contractures. Although people with SCI report that stretching is their preferred approach to reduce spasticity, limited evidence supports the use of stretching for people with SCI, including short-term (< one hour) effects on spasticity. Further, the long-term effects and the effects of stretching on motor function have yet to be examined in humans with SCI. Evidence from pre-clinical studies in rats with SCI demonstrates that stretching impairs motor output, reduces spinal cord excitability, and abolishes walking function. This perspective paper discusses evidence of static stretching in humans and rats with SCI regarding the effects on range of motion, joint contractures, and effects on voluntary and involuntary (i.e., spasticity) motor output. Additionally, we aim to challenge assumptions regarding the use of stretching and encourage research to advance the understanding of this common rehabilitation approach. Research is needed to investigate underlying mechanisms of stretch-induced effects and to advance stretching protocols to optimize the potential beneficial effects of stretching for people with SCI.
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spelling doaj-art-7e72fc14d50a4cabb448c8172e7ea4bc2025-08-20T02:22:06ZengFrontiers Media S.A.Frontiers in Rehabilitation Sciences2673-68612024-12-01510.3389/fresc.2024.15054391505439Stretching after spinal cord injury: a call for evidence for this common clinical practiceTodd E. Williams0Louis A. DeMark1Tinuade A. Olarewaju2Kelly A. Hawkins3Emily J. Fox4Emily J. Fox5Department of Physical Therapy, University of Florida, Gainesville, FL, United StatesBrooks Rehabilitation, Clinical Research and Motion Analysis Centers, Jacksonville, FL, United StatesDepartment of Physical Therapy, University of Florida, Gainesville, FL, United StatesDepartment of Physical Therapy, University of Florida, Gainesville, FL, United StatesDepartment of Physical Therapy, University of Florida, Gainesville, FL, United StatesBrooks Rehabilitation, Clinical Research and Motion Analysis Centers, Jacksonville, FL, United StatesStretching is a ubiquitous rehabilitation intervention for individuals with spinal cord injury (SCI), intended to reduce spasticity, maintain or improve joint range of motion, and prevent joint contractures. Although people with SCI report that stretching is their preferred approach to reduce spasticity, limited evidence supports the use of stretching for people with SCI, including short-term (< one hour) effects on spasticity. Further, the long-term effects and the effects of stretching on motor function have yet to be examined in humans with SCI. Evidence from pre-clinical studies in rats with SCI demonstrates that stretching impairs motor output, reduces spinal cord excitability, and abolishes walking function. This perspective paper discusses evidence of static stretching in humans and rats with SCI regarding the effects on range of motion, joint contractures, and effects on voluntary and involuntary (i.e., spasticity) motor output. Additionally, we aim to challenge assumptions regarding the use of stretching and encourage research to advance the understanding of this common rehabilitation approach. Research is needed to investigate underlying mechanisms of stretch-induced effects and to advance stretching protocols to optimize the potential beneficial effects of stretching for people with SCI.https://www.frontiersin.org/articles/10.3389/fresc.2024.1505439/fullstretchingrehabilitationmotor outputspasticitywalking functionspinal cord injury
spellingShingle Todd E. Williams
Louis A. DeMark
Tinuade A. Olarewaju
Kelly A. Hawkins
Emily J. Fox
Emily J. Fox
Stretching after spinal cord injury: a call for evidence for this common clinical practice
Frontiers in Rehabilitation Sciences
stretching
rehabilitation
motor output
spasticity
walking function
spinal cord injury
title Stretching after spinal cord injury: a call for evidence for this common clinical practice
title_full Stretching after spinal cord injury: a call for evidence for this common clinical practice
title_fullStr Stretching after spinal cord injury: a call for evidence for this common clinical practice
title_full_unstemmed Stretching after spinal cord injury: a call for evidence for this common clinical practice
title_short Stretching after spinal cord injury: a call for evidence for this common clinical practice
title_sort stretching after spinal cord injury a call for evidence for this common clinical practice
topic stretching
rehabilitation
motor output
spasticity
walking function
spinal cord injury
url https://www.frontiersin.org/articles/10.3389/fresc.2024.1505439/full
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